Preemptive analgesic efficacy of ultrasound-guided transversalis fascia plane block in children undergoing inguinal herniorrhaphy: a randomized, double-blind, controlled study / 대한마취과학회지

Background@#Surgical repair of congenital inguinal hernia results in significant postoperative discomfort and pain. The aim of the current study was to evaluate the pre-emptive analgesic efficacy of a transversalis fascia plane (TFP) block after pediatric inguinal herniorrhaphy. @*Methods@#Forty-four patients aged 12 to 60 months who underwent unilateral inguinal herniorrhaphy were enrolled. Four patients were excluded, and the remaining were allocated to the control group and the TFP block group. In the TFP block group, 0.4 mL/kg bupivacaine 0.25% was instilled in the plane between the transversus abdominis and transversalis fascia, while in the control group 0.9% saline was used instead of bupivacaine. The collected data were the total dose of paracetamol consumed during the first 12 h postoperatively, the postoperative Face, Leg, Activity, Cry, Consolability (FLACC) pain score, time to first use of rescue analgesia, number of patients required additional postoperative analgesics, and parents' satisfaction. @*Results@#The median paracetamol consumption was significantly lower in the TFP block group than in the control group, and FLACC pain scores were significantly lower for all study times in the TFP block group with higher parental satisfaction scores than those for the control group. The number of patients who required additional analgesics was significantly lower in the TFP block group than in the control group. @*Conclusions@#The use of a TFP block decreases postoperative analgesic consumption and postoperative pain intensity after pediatric inguinal herniorrhaphy. Future studies with larger sample size are required to evaluate the actual complications rate of TFP block.

Preemptive analgesic efficacy of ultrasound-guided transversalis fascia plane block in children undergoing inguinal herniorrhaphy: a randomized, double-blind, controlled study / 대한마취과학회지

Background@#Surgical repair of congenital inguinal hernia results in significant postoperative discomfort and pain. The aim of the current study was to evaluate the pre-emptive analgesic efficacy of a transversalis fascia plane (TFP) block after pediatric inguinal herniorrhaphy. @*Methods@#Forty-four patients aged 12 to 60 months who underwent unilateral inguinal herniorrhaphy were enrolled. Four patients were excluded, and the remaining were allocated to the control group and the TFP block group. In the TFP block group, 0.4 mL/kg bupivacaine 0.25% was instilled in the plane between the transversus abdominis and transversalis fascia, while in the control group 0.9% saline was used instead of bupivacaine. The collected data were the total dose of paracetamol consumed during the first 12 h postoperatively, the postoperative Face, Leg, Activity, Cry, Consolability (FLACC) pain score, time to first use of rescue analgesia, number of patients required additional postoperative analgesics, and parents' satisfaction. @*Results@#The median paracetamol consumption was significantly lower in the TFP block group than in the control group, and FLACC pain scores were significantly lower for all study times in the TFP block group with higher parental satisfaction scores than those for the control group. The number of patients who required additional analgesics was significantly lower in the TFP block group than in the control group. @*Conclusions@#The use of a TFP block decreases postoperative analgesic consumption and postoperative pain intensity after pediatric inguinal herniorrhaphy. Future studies with larger sample size are required to evaluate the actual complications rate of TFP block.

Moderate sedation with midazolam- ketamine versus propofolketamine for bone marrow biopsy

Small- dose ketamine in combination with sedative drugs has increasingly been used for sedation and analgesia during local anaesthesia in outpatient procedure. This study compared the efficacy of sedation and analgesia of ketamine midazolam versus ketamine propofol combinations in bone marrow biopsy. Sixty patients of either sex undergoing bone marrow biopsy procedure under local anesthesia participated in this study. They were randomly allocated into two groups of 30 patients each, all received ketamine 0.5 mg /kg with either midazolam 0.05 mg/kg [KM group] or propofol 2.5 mg/kg [KP group]. Supplementary dose of ketamine was administered to achieve adequate sedation level. Time to induce sedation, recovery oxygen time, saturation and adverse effects were recorded. The sedation levels were satisfactory in both groups except two patients in KM group and one in KP group. The most common side effects in KP group were pain on injection and hypoxia, where nausea and vomiting were the commonest side effects with KM group. Induction and recovery times were significantly shorter in KP group. Both combinations provided adequate sedation for bone marrow biopsy procedure but KP offer a quicker onset of sedation and a faster, smoother recovery

Effect of inoculum size on the activity of B-Lactam and aminoglycoside combinations against pseudomonas aeruginosa and staphylococcus aureus

Effects of inoculum size on the comparative activity of cefotaxime, cefazolin, ampicillin, gentamicin, streptomycin, amikacin and tobramycin against two strains of Pseudomonas aeruginosa and two strains of Staphylococcus aureus were studied by using 104, 106 and 107 cfu/ml. Inoculum size markedly affected the susceptibility of the studied strains to these antibiotics as well as their combinations. An increase in the inoculum size from 104 to 106 cfu/ml had more effects on the MIC than its increase from 106 to 104 cfu/ml. As regards the effect of inoculum size on the activity of the combinations, it was shown that the increase of inoculum size from 104 to 107 cfu/ml decreased the activity of cefazolin/streptomycin, ampicillin/tobramycin and cefazolin/tobramycin combinations, whereas inoculum size change did not exhibit any effect on cefotaxime gentamicin and ampicillin/amikacin

In-vitro interaction and stability of cefotaxime sodium and centamicin sulfate

The antibacterial activity of cefotaxime and gentamicin alone and in combination was tested against five strains of Escherichia coli using the checkerboard broth dilution and time kill study techniques. It was shown that the bacteriostatic activity of the combination was synergistic towards all the five tested strains. A similar bactericidal synergistic activity was also proved for the same combination against four of the studied strains, whereas the fifth revealed an indifferent effect. In addition, stability and compatibility of cefotaxime sodium, gentamicin sulfate alone or in combination were followed in 5% dextrose and 0.95 saline solutions prepared for parenteral administration. In this respect, the antibiotic concentration, pH value and visual appearance were followed at different time intervals beginning from 1 hour up to 48 hours. None of the two antibiotics alone or their combination when mixed in 5% dextrose or 0.9% saline has shown more than 10% loss or original concentrations after 48 hours